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ADDRESS Law <br /> PERC TEST PARCEL Perc DEPTH PERC RATE <br /> DATE OR LOT#. Hole# feet <br /> ( ) (min/inch) COMMENTS <br /> M <br /> DATE SAMPLED TYPE OF WELL NITRATE mg/L DBCP ug/L EDB ug/L COMMENTS(other address for well sampled) <br /> 1 VIle <br /> NITRATE LOADING <br /> RESULT(mg/L-N) SR#: SR �� �� �1 <br /> —�Lf(LCJ�IUI � SR Date: <br />